Provider Demographics
NPI:1174698328
Name:BAYNES, DAWN (PA)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BAYNES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 HARMONY XING STE 1
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-9546
Mailing Address - Country:US
Mailing Address - Phone:706-484-0884
Mailing Address - Fax:706-484-0885
Practice Address - Street 1:114 HARMONY XING STE 1
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-9546
Practice Address - Country:US
Practice Address - Phone:706-484-0884
Practice Address - Fax:706-484-0885
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004398363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ31943Medicare UPIN
GA97WCGDQMedicare ID - Type Unspecified